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Research Continues for GOJO Hand Hygiene Initiative

Posted Jan. 31, 2013

Four graduate students recently completed a second phase of research on hand hygiene among economically disadvantaged populations for Akron’s GOJO Industries, Inc., the leading global producer and marketer of skin health and hygiene solutions for away-from-home settings and inventor of PURELL® hand sanitizer.

Doctoral students Diana Kingsbury, Lorriane Odhiambo and Julie Schaefer, along with MPH student Sunita Shakya, conducted focus groups in November to gain greater understanding of hand hygiene practices in Africa, Asia and Latin America and to test hypotheses for encouraging better practices. Findings will assist GOJO as the company explores options for hand hygiene initiatives.

The three focus groups were composed of 36 international graduate and undergraduate students at Kent State. Discussions were structured to gain understanding of past and present hand hygiene practices and issues from multiple global perspectives. For example, the students examined whether school-age children could be catalysts in educating their parents and siblings to adopt new behaviors, an approach which has proven effective relative to smoking and seat-belt use.

The previous phase of the students’ research for GOJO, conducted during Spring Semester 2012, assessed the current state of hand hygiene in certain global regions and explained the complexity of interrelated health factors that, when combined, determine childhood mortality and illness outcomes. “Conducting focus groups was a logical progression from our initial work,” says Kingsbury. “We wanted to obtain the perspectives of people who came from diverse regions around the world,” she says.

“When I heard participants discuss washing their hands using ashes and leaves, it was all pretty new information to me,” observes Olds. There were fewer surprises for Odhiambo, who hails from Kenya. “The United States has all the necessary resources for hand hygiene, but compliance is poor, for example, in the health care setting,” she observes. “In Kenya, compliance is also very low, but the people don’t always have the resources, like in most developed countries. In rural areas especially, education and awareness about hygiene is a major factor influencing hand hygiene practices,” Odhiambo remarks. She plans a career in global health and infectious disease, in which hand hygiene plans a crucial role.

“Hands are a great vector for transmitting disease,” explains Olds. “You touch your face up to 2,000 times each day. The nose, mouth and eyes are portals for bacteria and viruses that your hands pick up from many different places, increasing your chances of getting sick,” he says. “Hand washing is a simple, yet effective, way of preventing disease from being spread, but access to water and soap in the developing world can be a real barrier.”

Focus-group findings were presented to GOJO on January 24. “The themes we presented highlight the unique challenges related to hand hygiene that were experienced by focus group participants in these regions of the world. The themes also describe the variety of individual, social and environmental barriers that underlie this health behavior,” says Kingsbury.

“I was intrigued by the basic need for hand hygiene education, as several of the focus group students recalled being asked to wash their hands as children, but weren’t necessarily shown how or told why they should do it,” says Bock. “GOJO recognizes the importance of hand hygiene education, and this qualitative work is valuable input for learning purposes.”

Next steps may include conducting additional focus groups in a specific region to learn more about local practices. In addition, the students plan to submit their findings for presentation at a future public health conference.

The overall context for the project is a 2008 study conducted in 42 childcare centers with limited clean tap water in six towns in Colombia. Authors were Juan C. Correa, Diana Pinto, Lucas A. Salas, Juan C. Camacho, Martín Rondón and Juliana Quintero. The study evaluated the effectiveness of alcohol-based hand rubs in reducing acute diarrheal diseases and acute respiratory infections, which are among the leading causes of death in Colombian children ages one to five. The study employed PURELL® hand sanitizer, the use of which significantly reduced diarrhea and respiratory ailments.

The Correa childcare center study concluded that the country’s disease-prevention policies should include use of alcohol-based hand rubs, especially in settings where hand washing with soap and water is limited by water availability. Findings were published in the June 2012 issue of the Pan American Journal of Public Health.

The history for collaboration with Kent State dates back to the early days of GOJO in the 1940s, when its founders sought expertise from chemistry professor Clarence Cooke. He assisted in the formulation of a hand cleaner that cut through, safely removed and easily rinsed tough soils from the hands of rubber workers. Throughout the years, numerous Kent State faculty members have collaborated with GOJO, and the company has frequently sponsored internships that draw students from across the university.